Westminster Homecare Limited (Aylesbury)

Updated 13 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 7 and 8 January 2019 and was announced. The provider was given short notice because the location provides a domiciliary care service. We needed to be sure someone would be available to assist us with the inspection and provide access to information and records. The inspection was carried out by two inspectors on the first day and one inspector on the second day. Two experts by experience made telephone calls to 32 people who used the service and eight relatives, on 9 and 10 January 2019. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Surveys were also sent to some service users and community professionals prior to the inspection. We have used feedback from these to help inform our judgements about the service. We contacted 18 staff by email, to invite them to provide feedback about the service.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed notifications and any other information we had received since the last inspection. A notification is information about important events which the service is required to send us by law.

We contacted the local authority commissioners of the service, to seek their views about people’s care.

During the visit to the office, we spoke with the registered manager and six other staff members. They included the branch trainer, a care co-ordinator, a field care supervisor, an administrator, a care worker and the operations support manager. We shadowed a care worker and visited three people in their homes.

We checked some of the required records. These included ten people’s care plans, three people’s medicines records, five staff recruitment files, staff training and development records. Other documents included a sample of policies and procedures, monitoring records, the staff handbook and the statement of purpose for the service.

Updated 13 February 2019

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the Aylesbury area. It is registered to provide a service to older adults, younger disabled adults and children. One hundred and fourteen people were receiving support from the service at the time of the inspection, none of these were children.

This inspection took place on 7 and 8 January 2019. It was an announced visit to the service.

We previously inspected the service in September 2017. The service was not meeting all the requirements of the regulations at that time. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions ‘safe’, ‘effective’, ‘responsive’ and ‘well-led’ to at least ‘good’. The action plan was completed and sent to us.

There had been changes to management of the service since the last inspection. A registered manager was in post. This is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

People spoke positively about their care workers. Comments included “Staff are friendly and kind. Some carers are exemplary,” “Lovely staff, very charming, friendly,” “Good service and very good carers,” “I’ve had nothing but kindness from all of them” and “The carers are always very pleasant and we chat.”

Staff described improvements to the culture of the service. They told us they received good support. Improvements had been made to staff training. None of the staff had any concerns about the practices they were asked to undertake as part of their duties. They understood about safeguarding people from abuse and said they would report any concerns. People who were supported by the agency told us they felt safe.

Each person had been assessed before they received a service from Westminster Homecare Limited (Aylesbury). Care plans had improved and recorded people’s preferences and support requirements in detail. Risk assessments had been written to assess the likelihood of people experiencing any harm or injury. Measures were put in place where risks were identified, to reduce the likelihood of harm.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Some people were supported with their medicines. These were handled safely and appropriate records were kept.

Staff were recruited using robust procedures to make sure people were supported by care workers with the right skills and attributes. Staff received appropriate support through a structured induction, which included all the training the provider considered mandatory.

People told us there were inconsistencies in when their care workers arrived to support them. For example, some of the feedback we received included “Arrival times can fluctuate within two hours and they never call to say they’re going to be delayed,” “Forever late with calls” and “Staff arrive at different times, you never know where you are. Always more than half an hour late.” We have made a recommendation to improve this area of practice.

People knew how to make a complaint. Their experiences of doing this varied. We have made a recommendation about monitoring responses to people’s complaints and concerns.

There were improvements to monitoring of the service, to ensure people received appropriate care and support. This included spot checks of care workers’ practice, care reviews and audits.

Records were maintained to a good standard and staff had access to policies and procedures to guide their practice.